Patient Centered Medical Home Model

Sunshine Health is committed to supporting its network providers in achieving recognition as Patient Centered Medical Homes (PCMH) and will promote and facilitate the capacity of primary care practices to function as medical homes by using systematic, patient-centered and coordinated care management processes. In alignment with the vision of DHHS, it is Sunshine Health’s goal to have all of its primary care providers recognized as a PCMH by an accrediting agency. Sunshine Health will support providers in obtaining either NCQA’s Physician Practice Connections®-Patient-Centered Medical Home (PPC®- PCMH) recognition or the Joint Commission’s Primary Care Medical Home Option for Ambulatory Care accreditation.

The purpose of the PCMH program is to promote and facilitate a medical home model of care that will provide better healthcare quality, improve self-management by members of their own care and reduce avoidable costs over time. Sunshine Health will actively partner with our providers, with community organizations, and groups representing our members to increase the numbers of providers who are recognized as PCMHs (or committed to becoming recognized) and who achieve the meaningful use of health information technology (HIT).

Sunshine Health has dedicated resources to ensure its providers achieve the highest level of PCMH recognition with a technical support model that will include:

Readiness survey of contracted providers

Education on the process of becoming certified

Resource tools and best practices.

From an information technology perspective, we will be offering several HIT applications for our network providers who are either recognized PCMH’s or are committed to becoming NCQA or Joint Commission accredited medical homes. Our secure Provider Portaloffers tools that will help support PCMH accreditation elements. These tools include:

Online Care Gap Notification

Member Panel Roster including member detail information

Trucare Service Plan

Health Record

Provider Overview Report

For more information on Patient Centered Medical Home recognition and best practice models visit the following web sites: